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误诊为回肠克罗恩病的转移性乳腺癌病例报告。

Case report of metastatic breast cancer mimicking ileal Crohn's disease.

作者信息

Maharajh Sandeep, Capildeo Kavi, Barrow Mickhaiel, Islam Shariful, Naraynsingh Vijay

机构信息

Medical Associates Hospital, St Joseph, Trinidad and Tobago.

Department of Clinical Medicine, The University of the West Indies, St Augustine, Trinidad and Tobago.

出版信息

Int J Surg Case Rep. 2021 Oct;87:106408. doi: 10.1016/j.ijscr.2021.106408. Epub 2021 Sep 15.

Abstract

INTRODUCTION

Lobular breast cancer (LBC) has an increased risk of gastrointestinal (GI) spread compared with ductal breast carcinoma. Breast cancer commonly metastasises to bone, lung, liver, central nervous system and rarely to the gastrointestinal tract. As the prognosis for breast cancer continues to improve with modern medical practice it is important to be aware of the various clinical presentations and the appropriate management of breast cancer metastases.

CASE PRESENTATION

We describe a case of a 60-year-old woman who presented with symptoms of bowel obstruction 30 months after undergoing mastectomy and adjuvant chemotherapy for LBC. A Computer Tomography (CT) scan showed terminal ileal thickening suggestive of Crohn's disease but histopathology revealed metastatic lobular carcinoma. Surgical resection to relieve her small bowel obstruction confirmed LBC.

CLINICAL DISCUSSION

This case illustrates an unusual presentation of metastatic breast cancer causing small bowel obstruction with radiological features mimicking Crohn's disease.

CONCLUSION

Patients with breast cancer can present with intestinal obstruction due to metastatic spread to the small intestine; this may resemble Crohn's disease clinically and radiologically.

摘要

引言

与导管性乳腺癌相比,小叶性乳腺癌发生胃肠道转移的风险更高。乳腺癌通常转移至骨、肺、肝、中枢神经系统,很少转移至胃肠道。随着现代医学实践中乳腺癌的预后持续改善,了解乳腺癌转移的各种临床表现及适当治疗方法很重要。

病例介绍

我们描述了一例60岁女性,在接受小叶性乳腺癌乳房切除术和辅助化疗30个月后出现肠梗阻症状。计算机断层扫描(CT)显示回肠末端增厚,提示克罗恩病,但组织病理学显示为转移性小叶癌。为缓解小肠梗阻进行的手术切除证实为小叶性乳腺癌。

临床讨论

该病例说明了转移性乳腺癌导致小肠梗阻的一种不寻常表现,其影像学特征类似克罗恩病。

结论

乳腺癌患者可因转移至小肠而出现肠梗阻;这在临床和影像学上可能类似于克罗恩病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d22/8449070/a1a0de89d712/gr1.jpg

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